Staph Toxins in Psoriasis, Atopic Dermatitis, and Redness

Title: Staphylococcal toxins in patients with psoriasis, atopic dermatitis, and erythroderma, and in healthy control subjects.
Authors: Tomi NS
Publication: J Am Acad Dermatol. 2005 Jul;53(1):67-72.

The authors wanted to evaluate whether infection by Staphylococcus aureus (S. aureus) bacteria is involved in the skin and nostrils of patients with:

  • Psoriasis
  • atopic dermatitis
  • erythroderma (redness of the skin)
  • skin infections
  • sepsis
  • and in healthy control subjects.

To do this, they conducted a staphylococcal enterotoxin test-reversed passive latex agglutination (SET-RPLAR) test to determine the presence of Staphylococcal enterotoxins A, B, C, and D.

The authors found Staphylococcus aureus in 22 out of 25 patients with atopic dermatitis and 15 out of 25 patients with psoriasis. The severity of the diseases (quantified by dermatological indexes) correlated significantly with the toxigenic strain (S. aureus that can secrete enterotoxins) in both cases.

The authors also found that all patients with erythroderma had S. aureus bacteria, mostly in their skin whereas only 12% of healthy subjects have toxin-negative S. aureus on their skin.

In atopic dermatitis, sepsis, and skin infections, enterotoxin C was most often detected, whereas in psoriasis it was toxin B that was most often detected.

The authors concluded that Staphylococcus aureus bacteria were present in more than 50% of patients with atopic dermatitis and psoriasis, and that the severity of the diseases correlated significantly with the enterotoxin production of the isolated bacteria strains. However, due to limitations in their experiments, other enterotoxins such as toxic shock syndrome toxin-1, which may play a role, were not evaluated.

Editor’s Note: sepsis is the presence of disease-causing microbes in the blood or tissues. An enterotoxin is a toxin producted by bacteria that attacks the mucous membranes of the intestine and can cause vomiting and diarrhea associated with food poisoning.

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